TMS and Medication-Resistant Depression

How dTMS can provide Effective Relief for Depression

For many people battling depression, traditional medication therapy from among the various antidepressants available (SSRIs, DSRIs, or tricyclic antidepressants) can be effective in treating the disorder. For others, however, side effects from the drugs can be prohibitive, or the medications themselves are ineffective. For these patients who are experiencing medication-resistant depression, there is a promising alternative.

Deep transcranial magnetic stimulation (dTMS) is gaining popularity among mental health providers as an effective treatment for major depressive disorder (MDD) and treatment-resistant depression. dTMS is a non-invasive procedure which involves a device placed against the scalp over the left prefrontal cortex. This device delivers short, intense magnetic pulses into the brain, which then cause neurons to fire electrical impulses. Over time, with repeated sessions, the electrical impulses stimulate a chemical reaction in the brain that eventually helps life mood.

Why Some Individuals are Medication-Resistant

Several factors can cause treatment-resistant depression. In fact, major depressive disorder that is treated by a mental health provider using antidepressant medications typically has a 50% failure rate. Some of the reasons for the lack of response to treatment include:

Comorbid psychiatric disorders. Often, in the treatment of depression, co-occurring conditions such as an anxiety disorder go undetected initially. When a patient also has an anxiety disorder–especially panic disorder and bi-polar disorder–there is a high likelihood of medication resistance. Other comorbid mental health disorders that may cause treatment-resistant depression are personality disorders, obsessive-compulsive disorder, and eating disorders.

Co-occurring substance abuse. Some recreational substances are depressants themselves, such as alcohol, barbiturates, opiates, and benzodiazepines. These will exacerbate the symptoms of depression and offset the efficacy of the medications. Also, substance abuse may cause the patient to miss their doses or be otherwise noncompliant with their treatment.

Comorbid medical disorders. Some underlying health conditions can be causing or contributing to depression, such as hypothyroidism, Cushing’s disease, and Addison’s disease. Other medical conditions that may contribute to depression are Parkinson’s disease, cancer, HIV, diabetes, and coronary artery disease. Medications being taken to treat those conditions may decrease the antidepressant’s effectiveness.

Certain features of the depression. Patients with depression who exhibit such symptoms as hallucinations or delusions are found to be less responsive to medication. In addition, those whose depressive episodes are long-term or severe, and those who are suicidal tend to be treatment-resistant.

Why dTMS is an Effective Alternative or Augmented Therapy Option

An individual suffering in the grip of utter despair that accompanies a major depressive disorder often continues to seek relief in alternative strategies. dTMS has been shown to be highly effective in treating depression without the side effects of antidepressants, which can include weight gain, sexual dysfunction, nausea, insomnia, and fatigue, among others.

In contrast, a patient receiving dTMS treatment is seated comfortably during the session with little or no negative effects, other than a minority of patients experiencing some tenderness on the scalp area where the treatment is administered. They are fully awake while receiving treatments and can drive themselves home afterward.

Some mental health practitioners prescribe dTMS treatment as an augmented therapy to a low dose antidepressant regimen. If the patient is not experiencing unpleasant side effects from the medication, the combination of the two has been shown to be very effective in long-term remission rates.

In 2012, researchers at Butler Hospital, along with colleagues nationwide, completed one of the first studies to evaluate TMS in clinical practice settings. Their findings confirmed that TMS is an effective treatment option for those patients with depression who have been identified as medication-resistant. States the author of the study, Linda Carpenter, M.D., “Naturalistic studies like ours, which provide scrutiny of real-life patient outcomes when TMS therapy is given in actual clinical practice settings, are the next step in further understanding the effectiveness of TMS.”

Author: Achieve TMS

Achieve TMS is the leading provider of Deep Transcranial Magnetic Stimulation depression treatments. With over 600 patients treated and countless success stories, we’ve brought hope back to those who have been suffering in silence."